Anthem Blue Cross and Blue Shield of California are separate, competing companies that offer comprehensive plans at the Individual and Small Group level.

Provider Networks Both companies have extensive doctor and hospital lists with 48,000 doctors and 400 hospitals up and down the state.  Typically the lists overlap with doctors/hospitals participating in both.  Occasionally there will be a doctor who participates with one company but not the other so it's best to check on your doctor.  Online Doctor Listing
Financial Strength  This really is the main reason to go with the "Blues".   Smaller or less efficient carriers are having difficulties with some filing for Bankruptcy.  If you are with a smaller carrier that is offering significantly reduced costs, they almost definitely raise rates, lower benefits, and/or leave the market entirely.  If you have developed health conditions, the other carriers will not pick you up at that time.  Anthem Blue Cross is owned by Wellpoint, named the most admired health care carrier in the nation three years in a row.  Blue Shield is a close second.
Plans Both companies offer a wide range of plans. Take a look at Cross for their Right Plan, Tonik ,Share PPO plans, Basic 1000 ( low cost hospital plan).  Shield has done well with the HSA qualified Preferred Savings plans and new Essential plans.  Click here to see how the Share plans and the Preferred Savings differ.                                                  back to top

Difference between HMO and PPO

Most people already have a strong preference between these two models but in case you a need a quick summary, here it is.
With a PPO, you have more flexibility to choose your doctors; you are not locked into a region or a primary care doctor.  You can self-refer yourself out to specialists.  The trade off is that you will help share the costs when you get sick or hurt in the form of a deductible or co-insurance.
With an HMO, you choose a Primary Care Physician who has more control over referral and/or decisions regarding your care.  You must remain within your medical group and within a geographic region.  The trade off with this more structured approach is that there will be less out of pocket when sick or hurt.  For example, for inpatient hospital, you may be looking at nothing out of pocket.
TIP  HMO's have become more expensive so compare the annual premium difference with PPO options to make sure you are not paying too much.
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How are pre-existing conditions handled

Getting Approved  When applying for coverage, the carrier will make their decision to approve/decline coverage and/or increase rates based on pre-existing conditions.  You can find more information on qualifying for health insurance.  They are mainly looking for current or ongoing situations.  They will also heavily weigh anything that is open-ended such as a doctor's request for a check up in the future which has not happened yet.  Medication now weigh heavily because of the associated cost.  You can run your situation by us first to see what the probable outcome might be.  The carriers cannot exclude a certain condition from coverage in order to approve a person's coverage.
Once Approved  If you have not had coverage in the prior 63 days before your effective date, there is a 6 month waiting period for pre-existing conditions.  This means they will not pay out for claims relating to pre-existing conditions until you have been on the plan for 6 months.  If you have not lapsed coverage more than 62 days up to your new effective date, the carrier will take into account your prior coverage against a 6 month waiting period.   back to top

Is my doctor on the list

You can check for your doctor or hospital below.  Make sure you specify HMO or PPO.  Sometimes, doctors are listed under medical group or a billing doctor so if you do not see your doctor on the list, call their office and ask if they EXAMPLE..."participate in the Blue Cross PPO network".

Online Doctor Listing                                               back to top

Can you breakdown the PPO's plans

This is a simple breakdown and you should read through the benefit summary for more detail but it helps to simplify the plans.

PPO plans breakdown into three main categories:  Office consultation, Prescriptions, and...pretty much everything else (hospital, labs/x-rays, emergency, surgery, etc..)  
Most plans offer some type of immediate coverage for the office consultation and generic drugs.  NOTE  Blue Cross' Basic 1000 PPO does not cover either and Shield's Preferred Savings makes these benefits subject to the deductible.  Keep in mind that there is usually a separate deductible (from $250 up to $750 depending on plan) for Brand Name drugs.  The "everything else" is typically subject to the main deductible ($500-$5000 depending on plan).  Once you meet your deductible, you pay a percentage until you reach your max-out-of-pocket.    back to top

What does the deductible mean

A deductible is an amount that you will pay first before the plan kicks in.  Keep in mind that you will still get the discounted rate (usually 30-60% off) on covered benefits, in-network even before you meet your deductible.  After the deductible is met, you typically go into a % of the discounted rate.  Some benefits such as maternity and brand name descriptions will have their own, separate deductible.    back to top

What does max-out-of-pocket mean

This basically lets you know how the plan will treat large bills...so called catastrophic or major medical coverage.  Your max-out-of-pocket let's you how much you will pay up to for covered benefits, in-network in a calendar year.  Usually, the max is per person up to two people maximum.  The Blue Shield Preferred Savings plans have a family deductible for 2 or more people on one plan.   back to top

Can the rates change

The rates can change by class (the entire state of California or county) or when you move up to a new age band (typically at 5 year increments such as age 35-39).  The stronger the carrier, the less severe and less often the rate increases.  Once approved, they cannot change rates based on your medical health or claims.  back to top

Can a child have a plan alone

Yes.  With either carrier, you have a single child or multiple siblings on one plan if they are under the age of 18.   back to top

What is needed to start the process

We basically need the completed health insurance application (download here or have a hard copy sent to you), and the first payment to the carriers for at least one month's worth of premium.  If there are medical records needed, they will request them directly from the doctor.  This completed information can be expedited by faxing (831-624-2902) us a copy of the app and check, and then sending the original in the mail: 
  Goodacre Insurance Services
  316 Mid Valley Center #283
  Carmel, Ca 93923

 Blue Cross has an online application and credit card option as well.  More information on applying for health insurance.        back to top

How long does it take

There are two different scenarios.  If the applicant is in good health and there isn't much the carrier wants to check into, we usually hear back in one to two weeks.  If the volume of applications is running high in underwriting, the time frame can be longer.  If the carrier wants further information on something listed in the application, they will request records directly from the doctor and this can delay the processing time.  It usually adds another 2-4 weeks depending on how quickly the doctor responds back to the request.   back to top

Do I submit payment with the application

The first month's premium must be submitted with the application.  This can be done with a check made out to the carrier or via credit card (for Anthem Blue Cross, Blue Shield of California, or Health Net of California).  If the application is not approved, this initial payment will be fully refunded.  back to top

Is there a fee to apply

There is no fee to apply.  Only the initial month's premium is submitted with the application.  back to top

Is a physical required

A physical is not required...only the completed application and first months premium.  Blue Shield may require a physical for applicants over the age of 55 who have not had one in the last two years.  back to top

How can I expedite the processing

Blue Cross has an online application which tends to process very quickly.  Otherwise, you can fax your completed application and copy of check (or credit card section) to 831-624-2902 to start the process immediately.  You would then mail the original if paying by check.  The credit card option just requires the faxed copy.  back to top

Am I locked in for a period of time

No.  The policy can be cancelled or renewed (by payment) month to month.        
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How is payment handled

There are a few options for payment with either carrier.
Billing - Shield monthly, quarterly    Blue Cross bi-monthly, quarterly
Credit Card Blue Cross allows monthly, bi-monthly, quarterly credit card deduction
Checking account auto-deduction monthly deduction.   back to top

Can I change my plan later

Downgrading is easy to do within the same kind of plan such as Share 500 to the Share 1500.  Upgrading is possible if you are in good health as it is subject to underwriting.   back to top

Why should I go with Goodacre Insurance Services

We concentrate on health insurance for California